Individual provider Active NPI

Ali Anwaar Qureshi, M.D.

  • Plastic Surgery Physician
  • Irvine, CA
National Provider Identifier
1922354281
Registry record updated Mar 31, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Plastic Surgery PhysicianTaxonomy code 208200000X
License
A150631 Issued in CA
Practice address
4968 Booth Cir Ste 105
Irvine, CA 92604-3366
Phone
(949) 701-4454
NPI assigned
Jul 24, 2012
Last updated
Mar 31, 2023By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 31, 2023

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Plastic Surgery Physician 208200000X A150631 CA Primary

Addresses

Primary practice location

4968 Booth Cir Ste 105
Irvine, CA 92604-3366

Mailing address

4968 Booth Cir Ste 105
Irvine, CA 92604-3366
Phone (949) 701-4454

Other practice location 1

660 S Euclid Ave
Campus Box 8238, 1150 NW Tower
Saint Louis, MO 63110-1010
Phone (314) 747-0541

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20200413002552 CA Practitioner - Plastic and Reconstructive Surgery 4981832953 Reassigns benefits to 2 organizations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
A150631CAMDPlastic Surgery Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Song Plastic Surgery, Inc. CurrentSince Mar 30, 2020 Accepting new patients

Locations

4968 Booth Cir
Ste 105
Irvine, CA 92604
Phone (949) 350-0115

800 Corporate Dr
Ste 280
Ladera Ranch, CA 92694
Phone (949) 388-1798

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1343088000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1680220800000",
    "number": "1922354281",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4968 BOOTH CIR STE 105",
            "city": "IRVINE",
            "state": "CA",
            "postal_code": "926043366",
            "telephone_number": "949-701-4454"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4968 BOOTH CIR STE 105",
            "city": "IRVINE",
            "state": "CA",
            "postal_code": "926043366",
            "telephone_number": "949-701-4454"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "660 S Euclid Ave",
            "address_2": "Campus Box 8238, 1150 NW Tower",
            "address_purpose": "LOCATION",
            "city": "Saint Louis",
            "state": "MO",
            "postal_code": "631101010",
            "country_code": "US",
            "telephone_number": "314-747-0541",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "QURESHI",
        "first_name": "ALI",
        "middle_name": "ANWAAR",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2012-07-24",
        "last_updated": "2023-03-31",
        "certification_date": "2023-03-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208200000X",
            "taxonomy_group": "",
            "desc": "Plastic Surgery",
            "state": "CA",
            "license": "A150631",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Irvine, CA

Sources for this page

Verify at the official NPI Registry.